A look through the latest literature: soft tissue surgery - Veterinary Practice
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A look through the latest literature: soft tissue surgery

Our monthly summary of the latest academic publications on this month’s spotlight topic of soft tissue surgery

Single-port laparoscopic-assisted abdominal cryptorchidectomy in dogs

Sieglinde David and others, Ghent University, Belgium

Cryptorchidism is a common disorder of sexual development in dogs, with a reported prevalence of between 2 and 24 percent, depending on breed. Abdominal cryptorchidism is a significant risk factor for the development of neoplastic changes and testicular torsion. The authors describe a modified laparoscopic cryptorchidectomy technique using a single-port endoscope. The method was used in 14 dogs, including five dogs that had bilateral abnormalities. There was one incident of a major complication in which the patient had a testicular artery haemorrhage that required conversion to open surgery. There were two cases of minor complications: a splenic laceration and a pneumoretroperitoneum. The authors note that the procedure can be performed by a single surgeon, therefore representing a less invasive alternative to multi-port laparoscopic-assisted or single-port multi-access laparoscopic cryptorchidectomy techniques.

Veterinary Surgery, 53, 460-467

Treatment of non-neoplastic proximal duodenal ulcers in dogs

Maria Chiara Sabetti and others, University of Parma, Italy

Peptic ulcers can affect the stomach or duodenum and are likely to cause continuous bleeding, which may be difficult to control. The authors investigated the role of the proximal duodenal vasculature in this condition by creating polyurethane casts of the gastroduodenal vessels in five dogs that had died from unrelated disorders. They compared the findings with those from 12 dogs that were entered into a treatment trial with proximal duodenal ulcers diagnosed by endoscopic examination. Six dogs responded to medical treatment, while the others were treated surgically by endoscopic electrocauterisation, surgical coagulation or resection of the proximal duodenum. Each of the six cases that were successfully treated surgically appeared to have a prominent venous plexus in the proximal duodenum.

Journal of Small Animal Practice, 65, 113-122

Thoracoscopic resection of lung masses associated with excellent clinical outcomes

Karen Park and others, North Carolina State University, Raleigh

Thoracoscopic lung lobectomy has been described in a few studies that focused largely on the technical aspects of the procedures used. To date, there have been no larger-scale studies to assess potential risk factors and evaluate the clinical outcomes in comparison with established open surgery techniques. The authors describe the findings in 61 cases, all of which survived to discharge; 56 were alive at the one-month follow-up. Median overall survival time was 311 days. Larger tumours and tracheobronchial lymphadenopathy identified on preoperative computed tomography scans were associated with a shorter post-operative survival time. There was no apparent association between survival time and other parameters, such as patient age, tumour diameter, adjuvant chemotherapy or incomplete surgical margins.

Journal of the American Veterinary Medical Association, 262, 674-679

Prognostic factors and outcomes in 64 cases of thymic epithelial tumours in cats

Thomas Marks and others, Royal Veterinary College, Hawkshead

Thymic epithelial tumours are an uncommon neoplasm occurring mainly in cats aged nine years or more. Clinical signs include dyspnoea, coughing, regurgitation, vomiting, weight loss and lethargy due to the compression of adjacent organs. The authors retrospectively examined 64 cases seen at three large referral hospitals. Their findings suggest that the surgical excision of these tumours is associated with a favourable long-term prognosis; however, late local recurrence is a risk, as further disease was detected in 11 cats at a median of 564 days following surgery. Cats with lesions classed as advanced Masaoka-Koga stage I and II tumours had an increased mortality risk, and such cases may benefit from closer active monitoring after surgery or adjuvant therapy.

Journal of Small Animal Practice, 65, 47-55

Transseptal puncture in the dog using 3D transoesophageal echocardiography

Justin Allen and others, VCA West Los Angeles Animal Hospital

Transseptal puncture involves accessing the left atrium from the right side through the intra-atrial septum. It may be used to enable left atrial decompression in patients with left atrial hypertension through the creation of an iatrogenic atrial septal defect. Such procedures are relatively common in human cardiac patients but are considered difficult and dangerous in veterinary patients. The authors describe their clinical findings from 159 canine cases. They conclude that transseptal puncture is safe and repeatable in experienced hands, particularly when guided by three-dimensional transoesophageal echocardiography. They also describe an alternative approach via the jugular vein, which they consider a preferable option in many patients.

Journal of Veterinary Cardiology, 51, 64-71

A bioresorbable polymeric wound matrix for managing open wounds in dogs

Alyssa Carrillo and others, University of Florida, Gainesville

Wound management strategies are aimed at encouraging rapid wound healing while reducing bacterial load and preventing further contamination. A bioresorbable polymeric matrix (MicroLyte Vet; Imbed Biosciences) used widely in human medicine has been made available for use by veterinary surgeons. The authors describe the results of using the product in 34 cases of injuries resulting from ulcers, surgical dehiscence, lick granulomas or different forms of trauma. In every case, complete wound healing was achieved, although three dogs required additional surgical intervention. The number of applications of dressing required ranged from 1 to 15, with wound closure by second intention healing taking from 2 to 12 weeks.

Topics in Companion Animal Medicine, 56-57, 100825

Para-ureteral cyst with ipsilateral hydroureteronephrosis in a rabbit

Typhanie Tan and others, University of Montreal, Quebec

A para-ureteral cyst is an epithelium-lined structure located next to the ureter and involving the ureteral wall. Such lesions are usually congenital but may be acquired. The authors describe the case of a two-year-old spayed female rabbit that presented with anorexia and decreased faecal output 12 months after an ovariohysterectomy. A 5 to 6cm diameter firm abdominal mass was palpated cranially to the urinary bladder. A contrast-enhanced computed tomography examination located a fluid-dense mass near the right ureter, along with a severe right-sided hydronephrosis and an ipsilateral hydroureter. The right kidney and ureter were successfully excised, and the patient made an uneventful recovery. Although such lesions are rare, they should be considered among the differential diagnoses in neutered female rabbits with an abdominal mass.

Journal of Exotic Pet Medicine, 47, 4-8

Advances in the treatment of pulmonary valve stenosis in canine patients

Brian Scansen, Colorado State University, Fort Collins

Pulmonary valve stenosis is considered the most common congenital cardiac abnormality in canine patients, with a particularly high prevalence in brachycephalic breeds. The author reviews the evidence on the anatomical findings of this condition and the effectiveness of different treatment options. He concludes that balloon pulmonary valvuloplasty (BPV) will remain the primary treatment for this condition, although it is not effective with all valve morphologies. High-pressure BPV should be offered to owners whose dog fails to respond to conventional balloon dilation and may be the first-line therapy in some cases. Meanwhile, transpulmonary stent implantation is an emerging therapy option that is more technically challenging but appears to be more effective than balloon dilation.Veterinary Clinics of North America: Small Animal Practice, 53, 1393-1414

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